Oral and monoclonal antibody treatments for relapsing forms of multiple sclerosis: effectiveness and value : final evidence report

Oral and monoclonal antibody treatments for relapsing forms of multiple sclerosis: effectiveness and value : final evidence report

Collection:
Health Policy and Services Research
Author(s):
Lin, Grace A., author
Whittington, Melanie D., author
Nikitin, Dmitriy, author
Agboola, Foluso, author
McKenna, Avery, author
Herron-Smith, Serina, author
Pearson, Steven D., author
Campbell, Jonathan D., author
Contributor(s):
Institute for Clinical and Economic Review, issuing body.
New England Comparative Effectiveness Public Advisory Council, issuing body.
Publication:
[Boston, Massachusetts] : Institute for Clinical and Economic Review, February 21, 2023
Language(s):
English
Format:
Text
Subject(s):
Antibodies, Monoclonal -- therapeutic use
Multiple Sclerosis, Relapsing-Remitting -- drug therapy
Treatment Outcome
Administration, Oral
United States
Genre(s):
Technical Report
Abstract:
We conducted a review of the clinical and cost effectiveness of oral and monoclonal antibody treatments that are considered first-line disease-modifying therapy (DMT) for the treatment of relapsing forms of MS. Because there were very few head-to-head trials between our treatments of interest, we conducted indirect comparisons via a network meta-analysis (NMA). Additionally, because ublituximab is the newest DMT and is currently awaiting a regulatory decision by the FDA, we assessed its efficacy and value compared with more established DMTs. We found that all DMTs decreased the annualized relapse rate (ARR) compared with placebo, with the monoclonal antibodies overall having a greater impact on this outcome compared with oral medications. Ublituximab showed comparable reduction in ARR versus other monoclonal antibodies and a relatively greater reduction compared with oral DMTs. For the outcome of confirmed disability progression (CDP), there was more uncertainty in the results. Overall, the monoclonal antibodies had numerically greater effects on CDP than oral DMTs. Changes to CDP at six months were not statistically different for ublituximab compared with other monoclonal antibodies. We had direct head-to-head randomized controlled trial (RCT) evidence for ublituximab compared with teriflunomide, which demonstrated a significant reduction in ARR and magnetic resonance imaging (MRI) lesions in the ublituximab group compared with teriflunomide.
Copyright:
Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
Extent:
1 online resource (1 PDF file (various pagings))
Illustrations:
Illustrations
NLM Unique ID:
9918697384906676 (See catalog record)
Permanent Link:
http://resource.nlm.nih.gov/9918697384906676